What Millennials Need to Know About Safeguarding Their Heart Health

Heart disease is an equal-opportunity offender — one that young people would be wise to pay attention to in an effort to prevent problems as they age.

“Our behaviors have consequences,” says Dr. Nisha Jhalani, director of clinical and educational services at the Center for Interventional Vascular Therapy at NewYork-Presbyterian/Columbia University Irving Medical Center. “What you put in your body in your teens and 20s, from smoking to bad diet choices, all wreak havoc internally, but you won’t pay until down the road, and by then it’s too late.”

Even if you think you’re in great shape, it’s important to pay attention to your heart early on, especially since some risk factors — high blood pressure, family history, and high cholesterol — don’t produce noticeable symptoms, Dr. Jhalani says. An estimated 90 percent of cardiac events are preventable with lifestyle changes. Here, she explains what millennials need to know to stay heart-healthy — now and in the future.

Why should millennials be concerned about their heart health when most people don’t get heart disease until they’re older?
You’re never too young to start paying attention to your heart health. Even children need to be screened for risk factors if they have a family history of heart disease. It’s shocking how many kids and teens are now being diagnosed with high blood pressure and high cholesterol.

For people without a strong family history of the disease, I think 20 is a good age to start talking with your doctor about how to keep your heart healthy. That’s when people are entering their adult life; they’re starting to think about the future. It’s also a time to start making choices that will affect you later — about what you eat, how often you exercise, how much alcohol to drink — all of these decisions have consequences down the road. Heart disease is the No. 1 killer of men and women, and preventing it early on is a whole lot easier than treating it.

What are some risk factors that young people might not be aware of?
One is not getting enough sleep. My favorite conversation to have with young patients is to ask them how much sleep they get each night. Most are shocked to find out that less than six hours is associated with an increased risk of heart disease.

I also find that many women are surprised when I ask them about health problems they may have had during pregnancy. Conditions such as gestational diabetes, preeclampsia, and gestational hypertension can all increase one’s risk of developing heart disease in the future. Nobody tells these women that if they’ve had these problems, they should be referred to a cardiologist sooner rather than later. People think of heart disease as primarily a man’s disease because men get it earlier. But after menopause it evens out, and women are more likely to die of heart disease than men.

What’s the most important thing a young person can do to protect his or her heart?
First off, never smoke. It is the biggest cause of preventable deaths.

After that, I would say it’s crucial to see your doctor regularly, even if you feel perfectly fine. That’s the only way to find out if you have some of the risk factors for heart disease, including high blood pressure or high cholesterol. Unfortunately, these conditions don’t typically produce overt symptoms that make you feel sick, so if you don’t go to the doctor for regular checkups, you won’t know if you’re at risk.

What about alcohol? Isn’t it supposed to be good for your heart?
There’s lots of buzz around how alcohol can have protective effects on the heart. It is true that people with moderate alcohol intake have lower rates of heart disease than nondrinkers, mostly by raising good cholesterol (HDL) levels. But in today’s world, alcohol intake is not always moderate — which means one drink per day for women or one to two drinks per day for men. If people drink in excess, alcohol can lead to high blood pressure, stroke, and heart failure. Binge drinking can also cause atrial fibrillation (irregular heart rhythm). I’m not saying that it’s necessary to live a stringent life. What’s key to remember is that everything is fine in moderation, alcohol included.

What are some of the biggest misperceptions about diet and exercise in relation to heart health?
That you have to be a perfect weight and exercise hard most days of the week. In terms of weight, yes, you want to have a body mass index (BMI) in the normal range, but you can be a bit overweight and still be healthy. The worst kind of fat to have is abdominal fat, so if you tend to gain around your middle, you want to watch for that. But I’m not in favor of strict diets. I think it’s important to avoid beverages loaded in sugar — we phased them out of vending machines and cafeterias here at NewYork-Presbyterian. And I really like the Mediterranean diet — lots of fruits and vegetables, healthy fats, fish, lean meats (if you choose to eat meat), plant-based proteins, nuts, and limit red meat.

The same moderate approach goes for exercise. The official recommendation for people is to get 30 minutes of exercise five or so days a week. But I know for me, getting to the gym during the week is pretty impossible, especially with a newborn. Instead, I try to take 15 minutes every day to clear my head and do some stretching. Then, on weekends, I make sure to do a workout or two that gets my heart rate up. That might mean going for a run or playing a sport. What may be most important is to just keep your body moving. I love my treadmill desk; I answer all my emails on it. Sitting is the new smoking — even people who exercise are more at risk for health problems if they sit at a desk for hours a day. So if you get up from your computer to stretch every half an hour, take time to breathe and focus on your stress level, and then work up a sweat on weekends, you’ll be in good shape.

I never want to advocate for things that are not sustainable. It’s important to not have unrealistic expectations, but to have a healthy, balanced lifestyle that you can continue. If you are a generally healthy person, you can have red meat on occasion, and occasional drinks — nobody is saying you have to give up everything.

Certain genetic variables contribute to heart disease risk. Dr. Jhalani suggests four questions young people should ask their parents.

1. Has anyone in the family had a heart attack, stroke, or sudden death at an early age, meaning younger than 55 for men and 65 for women?
2. Do you take medications for a chronic condition?
3. If you have a chronic condition such as high blood pressure or diabetes, at what age was it diagnosed?
4. Have you been screened for heart disease? If your parents’ answer is no, tell them they are overdue to discuss heart disease with their doctor.

For more information on how to protect your heart, visit here.